Portal hypertension in vinyl-chloride production workers

Portal hypertension was seen in seven patients who had been involved in the production of vinyl-chloride monomer for 4-15 years. Four presented with bleeding oesophageal varices. In liver biopsy specimens non-cirrhotic portal fibrosis was inconspicuous and was seen more clearly on wedge rather than needle biopsy specimens. The intrahepatic venous pattern was hardly distrubed. Three patients have done well following shunt surgery. In one patient an angiosarcoma developed, but fibrosis was a more common lesion and was probably not pre-malignant.